Impact of Prior Home Care on Length of Stay in Residential Care for Australians With Dementia |
| |
| Affiliation: | 1. Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia;2. Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia;3. Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia;1. Laboratory of Cardiovascular Sciences, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD;2. Department of Public Health and Infectious Disease, University “La Sapienza”, Rome, Italy;3. Loyola University Maryland, Baltimore, MD;4. Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delel Ricerche, Lanusei, Sardinia, Italy;5. Laboratory of Genetics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD;6. Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delel Ricerche, Cagliari, Italy;7. Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy;1. University of South Australia, UniSA Allied Health and Human Performance, Adelaide, South Australia, Australia;2. Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia;3. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia;4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;5. Department of Rehabilitation, Aged and Palliative Care, Flinders Medical Centre, Flinders University, Bedford Park, South Australia, Australia;6. South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia;1. School of Public Health, Herston, University of Queensland, Brisbane, Queensland, Australia;2. School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia;1. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria, 3052, Australia;2. NHMRC Cognitive Decline Partnership Centre, Level 3, Old Leighton Lodge (Building 8 via Gate 6), Department of Rehabilitation and Aged care (RACS), Hornsby Ku-ring-gai Hospital, Palmerston Road, Hornsby, New South Wales, 2077, Australia;3. School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, 3004, Australia;4. Brightwater Research Centre, Brightwater Care Group, Level 3, 355 Scarborough Beach Rd, Osborne Park, Western Australia, 6017, Australia;5. Helping Hand, 34 Molesworth St, North Adelaide, South Australia, 5006, Australia;6. Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia |
| |
| Abstract: | ObjectivesTo assess the impact of home care on length-of-stay within residential care.DesignA retrospective observational data-linkage study.Setting and ParticipantsIn total there were 3151 participants from the 45 and Up Study in New South Wales, Australia with dementia who entered residential care between 2010 and 2014.MethodsSurvey data collected from 2006‒2009 were linked to administrative data for 2006‒2016. The highest level of home care a person accessed prior to residential care was defined as no home care, home support, low-level home care, and high-level home care. Multinomial logistic regression and Cox proportional hazards were used to investigate differences in activities of daily living, behavioral, and complex healthcare scales at entering residential care; and length-of-stay in residential care.ResultsPeople with prior high-level home care entered residential care needing higher assistance compared with the no home care group: activities of daily living [odds ratio (OR) 3.41, 95% confidence interval (CI) 2.14‒5.44], behavior (OR 2.61, 95% CI 1.69‒4.03), and complex healthcare (OR 2.02, 95% CI 1.06‒3.84). They had a higher death rate, meaning shorter length-of-stay in residential care (<2 years after entry: hazard ratio 1.12; 95% CI 0.89‒1.42; 2-4 years: hazard ratio 1.49; 95% CI 1.01‒2.21). Those using low-level home care were less likely to enter residential care needing high assistance compared to the no home care group (activities of daily living: OR 0.61, 95% CI 0.45‒0.81; behavioral: OR 0.72, 95% CI 0.54‒0.95; complex healthcare: OR 0.51, 95% CI 0.33‒0.77). There was no difference between the home support and no home care groups.ConclusionsHigh-level home care prior to residential care may help those with dementia stay at home for longer, but the low-level care group entered residential care at low assistance levels, possibly signaling lack of informal care and barriers in accessing higher-level home care.ImplicationsBetter transition options from low-level home care, including more timely availability of high-level care packages, may help people with dementia remain at home longer. |
| |
| Keywords: | Dementia home care home support residential care long-term care nursing home |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
